The place of anticonvulsants and other putative mood stabilisers in the treatment of bipolar disorder.

While lithium is an effective mood stabiliser still in widespread clinical use, a significant proportion of patients either respond poorly or are unable to tolerate its adverse effects. In the 1960s and 1970s preliminary reports of the possible effectiveness of carbamazepine and valproate began to appear, with confirmatory controlled studies being undertaken in the 1980s and 1990s. In recent years, further putative mood-stabilising agents have been described, in particular some of the newer anticonvulsants and the atypical antipsychotics. This paper critically evaluates the current evidential basis for claims for the efficacy of these compounds in bipolar disorder.